[Congressional Record (Bound Edition), Volume 153 (2007), Part 18]
[Senate]
[Pages 25598-25601]
[From the U.S. Government Publishing Office, www.gpo.gov]




                                 SCHIP

  Mr. MARTINEZ. Madam President, I wish to shift the discussion, while 
I concur completely with the Senator from Texas and his assessment of 
floor management time, and I do believe we need to get about the 
business of a Defense authorization bill and not be sidetracked by 
other side issues.
  I wish to talk about another important issue that is coming before 
the Senate, which is the SCHIP program, one that I support, one that I 
want to see reauthorized, and one that I want to see expanded. To my 
colleagues on the other side of this debate, let's talk about expanding 
SCHIP. I support a $5 billion expansion. If that is not enough to cover 
the children this program is intended to cover, let's talk. Let's 
discuss what amount would cover these children: $5 billion, $10 
billion; I am in favor of opening that discussion.
  What I am against, what I oppose is expanding this program beyond the 
needs of the poor.
  The bill before us today expands the program beyond its original 
intent. It expands it to the point where we are making Government-
sponsored health care available beyond the intent and to include those 
in the middle class.
  For those who claim otherwise, let me read a quote from the chairman 
of the Senate Finance Committee. The chairman recently noted:

       Everyone realized that the goal of this legislation moves 
     us a giant step further down the road to nationalizing health 
     care.

  Nationalizing health care. Let's call it what it is. This is not a 
debate over whether we are going to provide health insurance for our 
Nation's low-income children--because we all agree we should do that--
this is a debate over whether we should nationalize health care.
  This is a significant ideological debate. Do we in this body--in this 
Nation--want a system of government versus private health insurance? Is 
it right to dramatically expand this program to middle-class families 
for the sake of being able to say we are insuring more? I support 
SCHIP. I support the program with the original mission of covering low-
income children who do not have health insurance. This bill we are 
debating today is not that program; it is not even close. It is bad 
policy. To take a program designed to help poor children and create a 
new entitlement for middle and upper income families, especially when 
this group already has access to private coverage, money set aside for 
low-income children should be used to cover low-income children.
  Make no mistake. This bill takes us down a one-way path. The bill 
takes the money intended for SCHIP and uses it as money to begin a 
program of socialized health care. For this reason, I cannot support 
this bill.
  Beyond the ideological shift of socializing health care, the funding 
portions of this bill will essentially eliminate health coverage for 
low-income children after 5 years.
  Under this plan, SCHIP outlays increase every year for the next 5 
years. But in the year 2013, they drop dramatically--to levels that 
will not sustain even the existing population of kids on SCHIP.

[[Page 25599]]

  The proposal, as written, will require the Government to either drop 
millions of children from health care in 2013 or impose a new tax to 
raise the $41 billion needed to sustain the increased levels of 
coverage.
  Additionally, this bill sets us up to cover an unintended population 
of adults. This plan would allow New York to expand their SCHIP program 
to cover middle-class families earning $82,600 per year, which is four 
times the Federal poverty level.
  Ironically, this means many families in New York will receive a 
government subsidy for insuring their children at the same time they 
are subject to the alternative minimum tax, a tax specifically designed 
to target wealthy Americans.
  By expanding coverage further up the income scale and to new 
populations, this bill takes away needed resources from those most 
vulnerable, low-income children.
  Several recent analyses show that for every 100 children made newly 
eligible for SCHIP, half of those would either lose or forgo private 
coverage they currently have. So why are we using taxpayer dollars to 
cover children who have insurance at the expense of those who don't?
  I truly believe this bill represents a fork in the road. We can 
either move toward a health care system that is patient focused, with a 
choice of providers, or one that leads us toward a Cuban-style health 
care system, with rationing of care, long waiting lines and, worse yet, 
no choice.
  Let me reiterate, the dispute is not whether children should have 
access to affordable health insurance; we all believe children should 
have that access. The dispute is how we should achieve that goal.
  SCHIP reauthorization in its current form will transform the program 
into a middle-class entitlement.
  A real compromise needs to be reached, one that keeps in the spirit 
of SCHIP; one that finds children currently eligible and signs them up 
for insurance; a compromise that doesn't simply broaden the program's 
eligibility so people on private health insurance all of a sudden have 
an option to move to Government-sponsored health insurance.
  Congress also needs to work on legislation that will help make 
insurance more affordable.
  Since the President has signaled his intention to veto this version 
of SCHIP reauthorization, it is essential we talk about viable 
alternatives--plans that would ensure the reauthorization of SCHIP that 
expand rather than diminish private health insurance and coverage for 
children.
  I have been working with some of my colleagues on such a plan--one 
that would bring a viable alternative to the debate we are currently 
having. This alternative would be composed of two elements: First, a 
full reauthorization of SCHIP. SCHIP should continue to cover children 
in families with incomes at or below 200 percent of the Federal poverty 
level. But we should also work to enhance outreach for those eligible 
but not signed up.
  We know there are poor children out there without health insurance. 
We may not agree on the number of them, but let's work harder to find 
them and sign them up for coverage.
  The second part should consist of a child health care tax credit. 
Rather than putting more people on a government-run program, let's 
advance tax credits to families with incomes between 200 percent and 
300 percent of the poverty level. This would cover the population 
targeted by this bill, but instead of forcing them to drop their 
current coverage, it would provide assistance to keep them in the 
current insurance plan. It would help families with employer-based 
insurance to add their children to their existing policies.
  If a family doesn't have insurance, this credit will provide the 
resources necessary to go out and purchase health care.
  I think this is something we can all agree to. These concepts are 
supported by both the left and right, from the Heritage Foundation to 
Families USA. So I urge my colleagues to reject the proposal before us 
today and, instead, come together and work to ensure access to health 
care for all low-income children.
  The PRESIDING OFFICER (Mr. Whitehouse). The Senator from Arkansas is 
recognized.
  Mrs. LINCOLN. Mr. President, I rise now somewhat in dismay, I 
suppose, but certainly disappointed in hearing the debate from the 
other side. When we first started SCHIP 10 years ago, what a great 
bipartisan effort it was. Under this administration, so many waivers 
have been granted for childless adults and for other different 
categories of individuals to be covered.
  What we have tried to do, in a bipartisan way in putting together the 
reauthorization of this bill, is rein in those waivers. I heard my 
colleague and friend from New Hampshire--he and I have talked often 
about our own children--say we are going to cover illegal immigrants. 
We are not only not going to cover them in this bill, we don't even 
cover those who have stood in line and go through the proper process to 
come here as legal residents until there has been certain proof of how 
long they have been here and the contributions they have made.
  I have great confusion about this effort to portray this 
reauthorization as something that is expanding. We are actually reining 
it in.
  I have to say, in listening to my colleagues talk about covering 200 
percent of poverty, I hope the American people understand that when we 
talk about 200 percent of poverty--my colleague from New Hampshire 
talked about it as if it was a lot of money. When you talk about 200 
percent of poverty, you are talking about a family of four trying to 
live on $41,300. Eighty percent of the people in the State of Arkansas 
whom I represent have an adjusted gross income of less than $50,000. As 
a parent myself, being blessed with two incomes coming into our 
household, a family raising and caring for a family of four on $41,300 
a year--talking about what you are paying for rent, for food, for 
utilities, and then to say that we as a Nation don't want to support 
you in caring for your children and seeing that they get good health 
care, that their health care needs are met; no, go into the private 
marketplace where the most expensive piece of health insurance you can 
purchase is in the private single-payer marketplace of health 
insurance.
  I have been disappointed by those comments we have heard this 
morning.
  I hope that as we look forward, in this bill, we prohibit any new 
waivers, waivers that were a part of the first piece of legislation 10 
years ago, and this administration granted many of those waivers. My 
State of Arkansas has been a beneficiary of many of those waivers. But 
the fact is that we rein them in. We prohibit waivers on childless 
adults, and as those childless adults are phased out of the program, 
the States can choose to put them in a block grant program and cover 
them in a much less percentage than what they are covered now. But they 
are not going to be in a children's program or a program designed for 
children.
  So I hope our colleagues will look at all the hard work and effort 
that has been put into this bill, to rein in much of the excess that 
came through those waivers from this administration, and will look at 
how we can focus on bringing about compromise and making sure we focus 
on the hard-working families that make up the fabric of this great 
Nation and do need the help and the support of all of us in making sure 
their children get the most basic of needs in health care coverage.
  I thank the Chair and look forward to the debate and encouragement 
from all our colleagues to bring about a bipartisan bill that moves 
this Nation forward in recognizing our greatest asset--our children.
  The PRESIDING OFFICER. The Senator from North Dakota is recognized.
  Mr. DORGAN. Mr. President, has the time for morning business expired?
  The PRESIDING OFFICER. The time for morning business expires in 120 
seconds.
  Mr. DORGAN. Mr. President, I ask unanimous consent to speak for 15 
minutes in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.

[[Page 25600]]


  Mr. DORGAN. Mr. President, this afternoon, I will be attending a 
hearing of the Senate Appropriations Committee. The Secretary of 
Defense will be there, the head of the Joint Chiefs of Staff will be 
there, as will someone from the State Department, and they will be here 
supporting a proposal by the President to the Congress that we supply 
up to $200 billion in additional funding for the war in Iraq and 
Afghanistan--all of it declared ``emergency,'' none of it paid for, and 
that is $200 billion for this year. That will take us to almost three-
quarters of a trillion dollars, with respect to the war in Iraq and 
Afghanistan, all added to the Federal debt as a result of a request by 
the President that it be emergency spending.
  I mention that only because we have been talking out here on the 
Senate floor about something called the children's health insurance 
program. It is a fraction of what we will be discussing this afternoon 
as emergency funding. The children's health insurance bill is fully 
paid for. That which came out of the Senate Finance Committee on a 
bipartisan basis to address the issue of health insurance for children 
and do so in a way that fully pays for it. It is a very different 
circumstance than exists with the President's request for war funding, 
for example.
  But it is interesting to me that the loudest moans in the Chamber of 
the Senate come when we take the floor of the Senate to talk about 
taking care of things here at home, taking care of basic things in this 
country.
  What is more basic than taking care of children and the health care 
of children? If it is not in first place, tell me what is in first 
place among your concerns about life. I am talking about the health of 
our children. If that doesn't rank No. 1, tell me what does. It ought 
to rank No. 1, front and center. Everybody individually, I think, would 
say the most important thing in my life is my children and my 
children's health. Yet we bring a bill to the floor of the Senate 
dealing with children's health, paid for, and it provides expanded 
coverage, coverage to those children who don't have coverage--millions 
of children whose health is now a function of how much money their 
parents have in their checkbook, and who, in some cases, are lying in 
pain, walking with a limp, suffering through agony but cannot go to a 
health care facility because their folks cannot take them because they 
don't have any money or insurance. Does anybody here believe we should 
not aspire to address that? And we have. We have a piece of legislation 
that is fully paid for----
  Mr. KENNEDY. Will the Senator yield?
  Mr. DORGAN. Compared to what we will hear this afternoon, a request 
for $200 billion of emergency funding for the war in Iraq and 
Afghanistan, none of it paid for, and this is a fraction of that to 
reach out to try to provide health insurance to America's children, 
particularly America's poor children.
  I am happy to yield for a question.
  Mr. KENNEDY. On the point the Senator makes about this being a matter 
that is paid for, it is not effectively costing the taxpayers any 
resources. As I understand it, it is going to mean an increase in the 
cigarette tax, and the implication of the increase in the cigarette tax 
is the fact that less children will be smoking; so you have a double 
value here, where we are not only getting coverage for the children but 
discouraging children from smoking, which will help and assist and make 
sure future generations are going to be healthier as well. I know the 
Senator is familiar with that argument. Does he think the 
administration has missed that point?
  Mr. DORGAN. I believe they have. It is a fact that this is paid for 
with revenue coming from the sale of cigarettes. It is also a fact that 
about 3,000 children a day will begin to smoke and become addicted to 
cigarettes, and 1,000 of them will ultimately die from that choice. The 
only chance you have to hook someone on cigarettes is to do it when 
they are kids. Does anybody know of anybody who is around 30 or 40 
years old sitting in a La-Z-Boy recliner and watching television and 
thinking, what have I missed in life? What have I not yet done that I 
should do? And they come up with the answer that I ought to start 
smoking. Does anybody believe that would happen? Of course it doesn't.
  We know now that smoking has dangerous health effects. The only 
chance you have to get someone to smoke, get them addicted for a 
lifetime, is to get kids addicted. So I think that which we do to 
persuade children not to smoke is something very important in our 
lives. It is also a contributor to a healthy lifestyle.
  Mr. KENNEDY. Will the Senator yield further?
  Mr. DORGAN. Yes.
  Mr. KENNEDY. Effectively, when the administration says this is going 
to be additional kind of spending, they leave out the fact that it is 
going to be funded--children's health--with a cigarette tax. Is the 
Senator familiar with the fact that the procedure, the process by which 
the children actually get the health insurance in the State is 
basically identical to what the administration asked on their 
prescription drug program? It is using the private sector in terms of 
the contract, and in terms of an individual getting coverage for their 
children. The worker will find out there are several alternatives from 
which they can make a choice. They are all based on the private sector.
  Therefore, I ask the Senator, is he somewhat troubled by the 
administration's opposition, since we have effectively tracked the 
delivery system that the administration has asked and it is being paid 
for independently from spending programs by the Federal Government and 
that the total expenditure, as the Senator I am sure has pointed out, 
is some $35 million over 5 years as compared to $120 billion dollars 
for the war in Iraq in a single year?
  Mr. DORGAN. In fact, the request before the Senate Appropriations 
Committee this afternoon for the war in Iraq is two requests: $145 
billion that now exists for this year, and we expect another $50 
billion on top of it. That is nearly $200 billion in one single year, 
totaling about three-quarters of a trillion dollars, over time none of 
it paid for. This program to provide health insurance to children is $7 
billion a year fully paid for.
  What bothers me about this issue is this clearly is an issue of 
trying to take care of things here at home. What is more important than 
taking care of a young child who is sick? It is interesting to me, we 
voted a while back about making English the national language. It is a 
reasonable request. If you want to become an American citizen, you 
ought to aspire to learn the language, English. Yet I come to the floor 
and I hear a foreign language. I don't understand what they are talking 
about: ``socialized medicine,'' ``Cuban-style, government-run health 
care.'' It seems to me they ought to speak English. I get so tired of 
people using these terms, such as ``socialized medicine.'' Yes, there 
is a government aspect to this issue. But as my colleague said, much of 
this is the private sector as well implementing it.
  I am so tired of people saying the Government can't do a thing. How 
about those firefighters climbing the World Trade Center and giving 
their lives as those buildings came down? You know what, they were on 
the public payroll, were they not? Public service, that is what they 
were doing. Government workers. How about the teachers taking care of 
our kids today in the classroom? Government workers; yes, they are. How 
about Dr. Francis Collins working at NIH, who gave us the owners manual 
for the human body with the mapping of the genome code? Are we proud of 
him? Government worker.
  I am a little tired of this language--``socialized medicine,'' 
``Cuban-style system.'' What a load. That is thoughtless rather than 
thoughtful debate. This is not some massive socialized medicine 
program.
  I say to my colleagues, look a 4-year-old child in the eye who is 
hurting and say to them: You know what, we made a decision that the 
question of whether you get to see a doctor or get to go to a clinic or 
get to go to a hospital today is a function of how much money your 
parents have, and if they don't have

[[Page 25601]]

the requisite amount of money, I am sorry, youngster; tough luck. I am 
sorry. Just bear the pain. We shouldn't do that. As a country, we 
shouldn't do it.
  What is a higher priority than our children and our children's 
health? How on Earth, given what we are doing, spending money in this 
Chamber, a $200 billion request this afternoon before the Senate 
Appropriations Committee, none of it paid for, on an emergency basis, 
$200 billion, and now we come with a $35 billion request fully paid for 
to address the issue of children who do not get health care, children 
who, when they get sick, do not have adequate health care--what is more 
important for this country?
  I don't understand. I have said from time to time, we have all these 
events in the Olympics for running and jumping. If ever there were an 
event for sidestepping, I have some gold medal candidates in this 
Chamber. Sidestepping the important issue--they don't want to talk 
about the question of why do you not want to address the health care of 
children. They want to talk about other issues--socialized medicine. It 
is a foreign language to me, but maybe not to some.
  I guess I would ask this question: Can we--not just on this subject 
but other subjects as well--can we come to the floor of the Senate and 
take some pride in taking care of business at home? My colleague from 
Oregon and I offered the only amendment that cut down a bit the $20 
billion--yes, with a ``B''--$20 billion this Congress passed for 
reconstruction in Iraq. A massive amount of it was wasted. Talking 
about health care, guess what. We gave a $243 million contract to a 
private contractor to rehabilitate 142 health care clinics in Iraq. An 
Iraqi doctor went to the Health Minister of Iraq and said: I would like 
to see the health clinics that were rehabilitated. The money is all 
gone. The Iraqi Health Minister said: In many cases, those are 
imaginary health clinics. The money is gone. Reconstruction in Iraq--
how about taking care of things at home? How about doing first things 
first? And you tell me what is in second place. The first place, in my 
judgment, is taking care of America's kids, and we don't do this 
through some massive Government program, through some socialized health 
care system, some Cuban-style system of Government programs. We do this 
in a thoughtful way, and we do it in a way that works.
  How do we know it works? Because this program has existed and been an 
exemplary program, and it has given low-income families an opportunity 
to believe that when their kids get sick and they don't have money and 
are having a tough time, they can still take their kids to a doctor. 
God bless them for knowing that and God bless the Congress and the 
President for doing something about it in past years.
  It is very different now. We are trying to expand the program to 
millions of additional kids, and we are told somehow this is a program 
that is unworthy, it cannot be done this way, it is some sort of big 
bureaucratic mess. Nothing could be further from the truth--nothing.
  I hope when the dust settles this week and we do the conference 
report, I hope we understand that this conference report is 
bipartisan--Senator Grassley, Senator Baucus, Senator Hatch, Senator 
Kennedy, and so many others have advanced this legislation on the 
floor, Republicans and Democrats. Let's pass this legislation, and 
let's hope the small amount of opposition in this Chamber will not 
deter us from doing what we know is best for the country. And, second, 
let's expect this President to sign it. I know he has threatened to 
veto the bill. Let's expect him to sign it because it is taking care of 
business at home and doing first things first.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. SMITH. Mr. President, I ask unanimous consent that I be permitted 
to speak as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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